Quiz game based Hematology

A 30-year-old female presents with spontaneous petechiae on both legs for three days. No family history of bleeding disorders.

Lab investigation: Decreased platelet count, D-dimer (normal)

Bone marrow examination: normal megakaryocyte

Which of the following is the most likely cause in this patient?

• Immune thrombocytopenia

• Von Willebrand disease

• Hemophilia A

• Disseminated intravascular coagulation (DIC)

• Acquired platelet dysfunction with eosinophilia

A 20-year-old male presents with gingival bleeding, petechiae on extremities, icteric sclera, and no hepatosplenomegaly.

Lab investigation: Hb 7.6 g/dL, elevated LDH, decreased platelet count and ADAMTS 13 activity.

Which of the following is the most likely cause in this patient?

• Immune thrombocytopenia

• Acquired platelet dysfunction with eosinophilia

• Thrombotic thrombocytopenic purpura

• Hemophilia A

• Von Willebrand disease

A 2-year-old boy presents with deep hematoma and large ecchymoses. Family history has recorded bleeding in the maternal uncle.

Lab investigation: normal platelet count, prolonged aPTT, decreased factor VIII activity, and VWF test is normal

Which of the following is the most likely mechanism of the defect in this patient?

• Immune mediated destruction (Autoantibodies destroy platelet)

• Deficiency of von Willebrand factor cleaving protease

• Mutations on VWF gene (12p13.3) resulting to reduced level of von Willebrand factor in blood

• A hereditary bleeding disorder caused by a lack of blood clotting factor VIII

• Fibrin deposition (consumption Platelet, coagulation factor)

A 70-year-old male presents with back pain for one month.

Lab: Hb 8 g/dL, WBC 6,000 cell/uL, Platelet 200,000 cell/uL, Reticulocyte 1%

PBS: RBC Rouleaux formation were seen

Total calcium is 14 mg/dL (high)

What is the most likely diagnosis in this patient?

• Dengue hemorrhagic fever

• Multiple myeloma

• Chronic myeloid leukemia

• Leukemoid reaction

• Acute myeloid leukemia

An 8-year-old boy presents with fever and petechiae for five days.

Lab: decreased WBC count and Platelet count

PBS: atypical lymphocytes were seen

Tourniquet test is positive

What is the most likely diagnosis?

• Chronic myeloid leukemia

• Leukemoid reaction

• Multiple myeloma

• Acute myeloid leukemia

• Dengue hemorrhagic fever

A 50-year-old female presents with high- grade fever and dysuria for three days.

Lab: WBC count 90,000 cell/uL, PMN with toxic granule and Dohle body were seen in PBS

What is the most likely lab results in this patient?

• Philadelphia chromosome positive

• High LAP score

• JAK 2 positive

• Bence Jones protein positive

• Increase fibrosis in bone marrow

Match the following

• ITP

• 
• APDE

• 
• TTP

• 
• DIC

• 
• Hemophilia A

• 

Match the following

• Chronic myeloid leukemia

• 
• Multiple myeloma

• 
• Polycythemia vera

• 
• Dengue hemorrhagic fever

• 
• Acute myeloid leukemia

•